Flawed Testosterone Analysis Spurs Misleading Media Headlines

The precipitous decline of men’s testosterone levels over the years is inevitable. Unless aging men replace their diminishing testosterone, they could succumb to any of the numerous health problems linked to low testosterone levels: frailty, muscle loss, weight gain, impaired cognition, fatigue, loss of self-confidence, depression, declining bone health, increased risk of type 2 diabetes, stroke, and cardiovascular disease.

Over the years, several studies have shown that testosterone replacement therapy improves multiple measures of men’s vitality, especially related to cardio-metabolic health.

Therefore, on November 5, 2013, we were startled to see headlines like “Testosterone Treatments Linked to Heart Risks” in the major news media.

This headline and others like it were prompted by a retrospective, observational study by Vigen and colleagues published in the September 5, 2013, issue of the Journal of the American Medical Association (JAMA). The study suggests testosterone therapy may increase the risk of death and certain cardiovascular events. However, there are several significant shortcomings in the study’s design and methodology, and the results conflict with an existing body of research.

Woefully Inadequate Testosterone Replacement

The goal of testosterone restoration in most cases is to restore youthful blood levels of the hormone. Typically, Life Extension┬« suggests men target a blood level of testosterone between 700 and 900 ng/dL for optimal health.

In studies designed to assess the impact of testosterone replacement therapy, one of the most important considerations is to measure subjects’ blood levels of testosterone regularly throughout the study period. This allows the scientists conducting the study to make sure subjects are taking their testosterone as directed and that their blood levels are rising as expected.

Unbelievably, in the flawed analysis by Vigen, only 60% of study subjects receiving testosterone had a follow-up blood test to assess their testosterone levels. Among them, average testosterone levels rose from a very low level of 175.5 ng/dL at baseline to a still far-from-optimal level of 332.2 ng/dL during testosterone therapy.

Raising testosterone levels from a paltry 175.5 ng/dL to only 332.2 ng/dL is unlikely to deliver robust health benefits. In fact, research has shown that restoring testosterone levels to 500 ng/dL or higher is associated with pronounced health benefits, whereas benefits may be less evident at lower levels.